Staging of bladder cancer with multiparametric MRI

Juri, Hiroshi; Narumi, Yasuo; Panebianco, Valeria; Osuga, Keigo

doi:10.1259/bjr.20200116

Cited by 34 publications

(27 citation statements)

References 25 publications

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“…Multi-institutional studies applying VI-RADs scoring (1-5) to mpMRI interpretation to determine local staging demonstrates high sensitivity and specificity when a cut off score of ≥3 is used to describe likelihood muscle invasion (34)(35)(36)(37)(38). VI-RADS scoring also reflects good to excellent interobserver reporting agreement, with indices of agreement ranging between 0.73 and 0.92 (34)(35)(36)(37). Despite this evidence, mpMRI has not yet established its place as recommended and preferred standard imaging for local bladder cancer staging in clinical guidance (3).…”

Section: Current Role Of Mr Imaging In Bladder Cancermentioning

confidence: 99%

MR-Guided Adaptive Radiotherapy for Bladder Cancer

et al. 2021

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Radiotherapy has an important role in the curative and palliative treatment settings for bladder cancer. As a target for radiotherapy the bladder presents a number of technical challenges. These include poor tumor visualization and the variability in bladder size and position both between and during treatment delivery. Evidence favors the use of magnetic resonance imaging (MRI) as an important means of tumor visualization and local staging. The availability of hybrid systems incorporating both MRI scanning capabilities with the linear accelerator (MR-Linac) offers opportunity for in-room and real-time MRI scanning with ability of plan adaption at each fraction while the patient is on the treatment couch. This has a number of potential advantages for bladder cancer patients. In this article, we examine the technical challenges of bladder radiotherapy and explore how magnetic resonance (MR) guided radiotherapy (MRgRT) could be leveraged with the aim of improving bladder cancer patient outcomes. However, before routine clinical implementation robust evidence base to establish whether MRgRT translates into improved patient outcomes should be ascertained.

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Section: Current Role Of Mr Imaging In Bladder Cancermentioning

confidence: 99%

MR-Guided Adaptive Radiotherapy for Bladder Cancer

et al. 2021

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“…As MRI has been extensively used to assess BC, there are possible lessons learned that could be applied to assess IC issues. For instance, multiparametric MRI is now being investigated to assess urinary BC, which includes DWI and/or DTI, dynamic contrast-enhanced (DCE) imaging, T2-weighted imaging, perfusion-weighted imaging (PWI), and measurement of T1 and T2 relaxation time constants [ 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 ]. As mentioned above, DWI and CE-MRI have already been considered for assessing bladder wall alterations associated with IC, however, adding changes in T1 and T2 relaxation values, as well as including T2-weighted imaging and PWI to the mix, may provide additional information on tissue structural damage (T1, T2, T2-weighted contrast) and vascular alterations (PWI).…”

Section: Mri Imagingmentioning

confidence: 99%

MRI as a Tool to Assess Interstitial Cystitis Associated Bladder and Brain Pathologies

et al. 2021

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic, often incapacitating condition characterized by pain seeming to originate in the bladder in conjunction with lower urinary tract symptoms of frequency and urgency, and consists of a wide range of clinical phenotypes with diverse etiologies. There are currently no diagnostic tests for IC/BPS. Magnetic resonance imaging (MRI) is a relatively new tool to assess IC/BPS. There are several methodologies that can be applied to assess either bladder wall or brain-associated alterations in tissue morphology and/or pain. IC/BPS is commonly associated with bladder wall hyperpermeability (BWH), particularly in severe cases. Our group developed a contrast-enhanced magnetic resonance imaging (CE-MRI) approach to assess BWH in preclinical models for IC/BPS, as well as for a pilot study for IC/BPS patients. We have also used the CE-MRI approach to assess possible therapies to alleviate the BWH in preclinical models for IC/BPS, which will hopefully pave the way for future clinical trials. In addition, we have used molecular-targeted MRI (mt-MRI) to quantitatively assess BWH biomarkers. Biomarkers, such as claudin-2, may be important to assess and determine the severity of BWH, as well as to assess therapeutic efficacy. Others have also used other MRI approaches to assess the bladder wall structural alterations with diffusion-weighted imaging (DWI), by measuring changes in the apparent diffusion coefficient (ADC), diffusion tensor imaging (DTI), as well as using functional MRI (fMRI) to assess pain and morphological MRI or DWI to assess anatomical or structural changes in the brains of patients with IC/BPS. It would be beneficial if MRI-based diagnostic tests could be routinely used for these patients and possibly used to assess potential therapeutics.

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“…The mp-MR imaging allows for high soft tissue contrast resolution and multiplanar imaging, and enables radiologists to predict the depth of tumor invasion. [13,14,15,16]. Current mp-MR imaging require improvements in efficiency, accuracy, and consistency to improve BC staging.…”

Section: Limitations Of Multi-parametric Magnetic Resonance Imagingmentioning

confidence: 99%

“…It lacks reliable discrimination of muscle invasion to reduce or eliminate pathologic staging with TURBT. [16,17,18,19]. Magnetic resonance image evaluations are a tedious, slice by slice process whose effectiveness depends upon the experience of the radiologist.…”

Section: Limitations Of Multi-parametric Magnetic Resonance Imagingmentioning

confidence: 99%

Bladder segmentation based on deep learning approaches: current limitations and lessons

Bandyk,

Gopireddy,

Lall

et al. 2021

Preprint

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Precise determination and assessment of bladder cancer (BC) extent of muscle invasion involvement guides proper risk stratification and personalized therapy selection. In this context, segmentation of both bladder walls and cancer are of pivotal importance, as it provides invaluable information to stage the primary tumor. Hence, multiregion segmentation on patients presenting with symptoms of bladder tumors using deep learning heralds a new level of staging accuracy and prediction of the biologic behavior of the tumor. Nevertheless, despite the success of these models in other medical problems, progress in multiregion bladder segmentation is still at a nascent stage, with just a handful of works tackling a multiregion scenario. Furthermore, most existing approaches systematically follow prior literature in other clinical problems, without casting a doubt on the validity of these methods on bladder segmentation, which may present different challenges. Inspired by this, we provide an in-depth look at bladder cancer segmentation using deep learning models. The critical determinants for accurate differentiation of muscle invasive disease, current status of deep learning based bladder segmentation, lessons and limitations of prior work are highlighted.

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Staging of bladder cancer with multiparametric MRI

Cited by 34 publications

References 25 publications

MR-Guided Adaptive Radiotherapy for Bladder Cancer

MR-Guided Adaptive Radiotherapy for Bladder Cancer

MRI as a Tool to Assess Interstitial Cystitis Associated Bladder and Brain Pathologies

Bladder segmentation based on deep learning approaches: current limitations and lessons

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